Voluntary medical male circumcision (VMMC) is a low-cost, minimally invasive procedure that offers several benefits to recipients, including reduced risk of the transmission of sexually transmitted infections (STIs). Following a multi-country, randomized
controlled trial, VMMC was shown to reduce men’s risk of acquiring HIV from female sex partners by 60 percent.1 Based on these findings, in 2007 the World Health Organization (WHO) and the United Nations Program on AIDS (UNAIDS) added the procedure to their list of recommended HIV prevention strategies. In 2010, Uganda’s Ministry of Health (MOH) set an ambitious target of reaching 80 percent of eligible men with VMMC services by 2016 to reduce HIV prevalence nationwide. At the time, the proportion of eligible men who were circumcised in the East Central Region was roughly 37 percent.
Following the national VMMC target setting in 2010, STAR-EC began a fast-moving initiative to integrate VMMC into existing health services, working within the MOH’s decentralized health system. The project introduced and rapidly scaled up VMMC services both at health facilities and at the community level via outreach clinics to reach as many clients as possible in the nine districts that comprise Uganda’s East Central Region. STAREC’s strategy included an aggressive community mobilization and education initiative to drive up demand for the procedure among sexually active men. The project targeted populations at high risk for acquiring HIV through sexual contact, which include fishermen, boda boda (motorcycle taxi) drivers, and truck drivers. Among these highly mobile, often hard-to-reach groups, VMMC, a one-time procedure, is a particularly effective strategy for reducing overall HIV prevalence in the general population. When the STAR-EC project began in 2009, VMMC services were largely unavailable in the East Central Region of Uganda. STAR-EC/JSI, 2016
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